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GET A QUOTE – COMMERCIAL PROPERTY
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2022-10-13T12:28:27-05:00
GET A QUOTE FOR COMMERCIAL PROPERTY
Effective Date of Policy Desired
(Required)
MM slash DD slash YYYY
Detailed Description (Operations) of Services Offered
(Required)
Owner(s)
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Mailing Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Physical Address: (if different)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Years of Experience
(Required)
Business Information
Full Name of Business
(Required)
Business Type
(Required)
Sole Proprietorship
Partnership
LLP
LLC
Series LLS
C corporation
S corporation
Nonprofit Corporation
Benefit Corporation
L3C
Business Start Date
(Required)
MM slash DD slash YYYY
Mailing Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Physical Address: (if different)
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Do you have current coverage in place?
(Required)
Yes
No
If so, who is the insurance company(s)
(Required)
How many years with this company?
(Required)
Have any claims been filed in the last 5 years?
(Required)
Building – Contents - Equipment Coverage
Do you own or rent?
(Required)
Own
Rent
If you rent – does your lease make you responsible for the a/c or any improvements / betterments?
(Required)
Do you have more than one location?
(Required)
Yes
No
Age of Building (year built)
(Required)
Number of Stories
(Required)
Total Square Footage of Building
(Required)
Square footage of space you occupy
(Required)
Age of Roof
(Required)
Type of Roofing material
(Required)
If more than 15 years old – what years was the electric updated
If more than 15 years old – what years was the plumbing updated
If more than 15 years old – what years was the HVACupdated
Construction type of Exterior Building
(Required)
Is the building sprinklered
(Required)
Yes
No
Do you have a monitored fire alarm system?
(Required)
Yes
No
If so what is the percentage?
(Required)
Do you have a monitored burglar alarm system?
(Required)
Yes
No
Amount of Replacement coverage needed for the building
(Required)
Amount of Replacement coverage needed for your business contents
(Required)
Amount of Loss of Income Coverage needed?
(Required)
Equipment – anything valued over $2500 will need to be specifically scheduled, if over $2500 – need year, make, model, serial #, and value, if under $2500 in value – lump value together and give one whole number for coverage
Equipment Coverage Amount needed?
(Required)
Anything over $2500 can be listed out in the Additional Notes section with Year, Make, Model, Serial Number and value for each item.
If you own the building, but do not occupy it, who are your tenants?
(Required)
What percentage of the building is occupied
(Required)
Do you have a mortgage company or landlord that needs to be listed on the policy?
(Required)
Yes
No
If so, we will need their name and address
(Required)
Additional Notes
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